Since the human papillomavirus (HPV) vaccination was added to the Kingdom’s national immunisation schedule, Cambodian health authorities have ensured that nearly all nine-year-old Cambodian girls have received the potentially lifesaving inoculation.

Phen Lina, a mother of three, mirrors the cautious sentiment of many parents as she deliberates over vaccinating her daughter, now twelve years old, against HPV.

“I am not quite sure when I am going to take her for vaccination but I will. Let’s wait until I have time,” Lina says, reflecting a common lack of urgency among parents regarding this crucial vaccine.

Despite her hesitancy, the significance of the HPV vaccine cannot be understated, especially in a country like Cambodia, where cervical cancer ranks as the second most common and third deadliest cancer among women. 

According to the Global Cancer Observatory (GLOBOCAN), the Kingdom sees about 18,000 new cancer cases every year, with the number projected to rise to almost 32,000 by 2040. Women most commonly experience breast (19.1%), cervical (11.5%), and liver (10.8%) cancers.

Thanks to a comprehensive national campaign that began in October last year, a whopping 99 per cent of targeted nine-year-old girls received the HPV vaccine by the end of the year, according to the Cambodia Health Information Management System (HMIS).

During the launch of the campaign, Minister of Health Chheang Ra stressed the importance of safeguarding the health of all girls nationwide. 

“We will ensure that all nine-year-old girls receive one dose of the HPV vaccine free of charge, and plan to provide inoculations to all girls above nine years old through a campaign in 2025,” he said.

Thanks to the addition of the vaccine to the Kingdom’s routine vaccination schedule, nearly all nine-year-old girls’ cohort of 2023 are now covered, according to Anirban Chatterjee, deputy representative of UNICEF Cambodia.

He explained that the initiative is part of a broader strategy to integrate the HPV vaccine into the country's routine vaccination schedule, which promises a sustained defence against cervical cancer for future generations.

Citing the Cambodia Health Information Management System (HMIS) portal reports, Chatterjee said that as of December 31 last year, 145,742 nine-year-old girls had received the vaccine.

The Cambodian government, in collaboration with major global health organizations like Gavi, the Vaccine Alliance, WHO, and UNICEF, offers HPV vaccines free of charge to all nine-year-old girls nationwide through regular school and community vaccination outreach sessions and year-round services at health centres.

They aim not only to protect girls at a young age but also to educate the community about the importance of early vaccination. 

“The vaccine is free, easily accessible, and safe—and it is most effective at this young age, before the risk of exposure to the virus,” Chatterjee told The Post.

“During the vaccination sessions, UNICEF supported outreach efforts that reached more than 210,000 people, providing information to caregivers, parents, and children about the importance of the vaccine,” he added.

The urgency of this campaign is underscored by the grim statistics. Each year, hundreds of women in Cambodia lose their lives to cervical cancer, a disease closely linked to HPV – a virus with over 20 strains which are capable of triggering cancer, according to Professor Dr. Eav Sokha, a cancer expert. 

Sokha, a distinguished cancer specialist with 26 years of experience, notably founded a post-Pol Pot cancer rehabilitation unit in 2003.

“Fortunately, the HPV vaccine has demonstrated a high efficacy rate, with a noted 97 per cent effectiveness in preventing the types of HPV most likely to cause cervical cancer,” he said.

Sokha noted the effectiveness of the inoculation, particularly among young, unmarried individuals aged 9 to 26, although its efficacy decreases with age.

“Even after vaccination, women should undergo annual cervical cell checks until the age of 72 to detect any abnormalities that may develop into cancer,” he told The Post. 

Despite the clear benefits and strong governmental and international backing, challenges remain in reaching all segments of the population. 

Lina’s hesitancy is not unique; it stems from a broader lack of awareness about the vaccine's importance.

To bridge this gap, UNICEF's targeted digital campaigns have reached approximately 1.5 million individuals, disseminating crucial information about the benefits of HPV vaccination.

Chatterjee noted that cervical cancer is a devastating disease that affects women globally, especially in lower- and middle-income countries. 

In Cambodia, it leads to the loss of hundreds of lives each year. 

The HPV vaccine is a powerful tool against cervical cancer as it offers a safe and effective means of preventing infection with the human papillomavirus. 

Cervical cancer is a type of cancer that occurs in the cervix, the lower part of the uterus that connects to the vagina and is caused by persistent infection with certain types of high-risk HPV.

“By vaccinating girls at an early age, we can reduce their risk of developing this deadly disease later in life, thereby also reducing the burden of non-communicable diseases in the country,” said Chatterjee.

“Our goal in supporting the Ministry of Health is to prevent cervical cancer and secure a healthier future for girls,” he added.

Chatterjee urged all parents and caregivers to ensure that their daughters receive the vaccine, emphasising the importance of providing the best start in life for every girl.

Sokha highlighted the asymptomatic nature of early-stage cervical cancer, underscoring the importance of vigilance and the need to seek medical attention upon experiencing symptoms such as post-coital bleeding, abnormal vaginal discharge, excessive menstrual bleeding, and pelvic or lower back pain. 

“Immediate consultation with an oncologist or hospital is advised for timely diagnosis and treatment,” said the cancer specialist from Phnom Penh’s Orange Cancer Clinic.

The Post was unable to obtain comment from Ork Vichit, deputy director of the National Maternal and Child Health Center and Manager of the National Immunisation Programme.

On multiple occasions, Vichit declined to comment, saying he was in meetings or otherwise engaged.

According to Chatterjee, looking ahead to mid-2025, the health ministry plans to expand the vaccination campaign to cover girls up to fourteen years old, further cementing its commitment to eradicating cervical cancer in Cambodia. 

This ambitious effort also sets a hopeful precedent for other nations battling similar public health challenges, including neighbouring nations Thailand and Vietnam, where far lower vaccination rates are recorded.